Morgantown, W.Va.-based WVU Health System reached a settlement with the Pennsylvania attorney general’s office that places conditions on its acquisition of Greensburg, Pa.-based Independence Health System. The deal marks an expansion of WVU Health System’s Pennsylvania footprint. It has operated…
Legal & Regulatory Issues
The FTC has vowed to block “bad hospital deals” after it helped steer Fairfield Medical Center in Lancaster, Ohio, away from Columbus-based OhioHealth’s planned purchase and toward a Sept. 1 acquisition by Chillicothe, Ohio-based Adena Health. A previous FTC staff…
The midterm election is right around the corner, and healthcare costs are a top issue on the ballot. More than half of voters said healthcare costs are extremely important for candidates to discuss, according to a July KFF poll. With…
Anosh Ahmed, MD, former CFO and COO of Chicago-based Loretto Hospital, pleaded not guilty Aug. 31 to a 15-count fraud and money laundering indictment connected to COVID-19 testing fraud claims, the Chicago Tribune reported. “Nice to see you here in…
The Justice Department’s scrutiny of Medicare Advantage risk adjustment is intensifying, with two recent settlements totaling nearly $1.1 billion highlighting federal concerns about diagnosis coding practices that can increase payments to health plans. The latest came Aug. 27, when The…
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George Miller Jr., the former CEO of Loretto Hospital in Chicago, entered into an agreement to defer prosecution on a federal conspiracy charge connected to the hospital’s embezzlement scandal, according to an Aug. 25 filing in the U.S. District Court…
Maryland Attorney General Anthony Brown has filed a lawsuit against UnitedHealth Group and Optum, seeking $380 million in damages stemming from alleged issues administering a Medicaid behavioral health program. “Marylanders in crisis and the providers who care for them rely…
A state grand jury determined that $10 million from a Centene Medicaid settlement was “misappropriated” under Florida Republican Gov. Ron DeSantis’ administration, according to a Jan. 28 sealed document obtained by CBS News Miami. Despite the findings, the document said…
The Villages (Fla.) Health, a primary and specialty care provider group, has agreed to pay $541.5 million to resolve allegations that it violated the False Claims Act by submitting improper Medicare Advantage diagnosis codes, according to an Aug. 26 news…
A Portland, Ore., man is suing Oakland, Calif.-based Kaiser Permanente for nearly $534 million, alleging the health system and several physicians failed to properly diagnose and treat a heart condition that led to cardiac arrest and the amputation of both…